| NPI | 1265695571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 20A12298) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 20A12298) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2024-08-08 |